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Why less ERT than I make naturally? Why less ERT than I make naturally?

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Unread 10-11-2010, 04:35 PM
Why less ERT than I make naturally?

I'm having a hyst/bso on 11/20 and I'm starting to consult about HRT in advance of the surgery. The first doc I spoke to said the goal of ERT isn't to match my pre-surgical hormones (I'm in perfect health but BRCA 2) but to give me the lowest dose that alleviates whatever menopausal symptoms show up. This sounds less than scientific to me. I've had my breasts removed prophylactically and now won't have a uterus or ovaries so very little risk of cancer. Why wouldn't the goal be to match what a healthy woman of comparable age produces naturally to keep my other organs and bones healthy and prevent any menopausal symptoms from showing up in the first place? Any thoughts? Also, would a bio-idenical hormone specialist have the same philosophy or might they be more open to the idea of replacing my hormones at age-appropriate levels?
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Unread 10-11-2010, 08:13 PM
Re: Why less ERT than I make naturally?

Unfortunately, many Dr's are of this mindset. I am not. Why not be at an optimal level so we can feel good, not just get by? I went to 7 or 8 different Dr's until I found a Dr that had the same thinking. You may have to do a bit of searching for a Dr that will help you. I recommend starting at your local compounding pharmacy. Ask them which Dr's in your area prescribe bioidentical hormones. They may be able to tell you which ones are more open-minded. Good luck!
Unread 10-11-2010, 09:11 PM
Re: Why less ERT than I make naturally?

I don't think your Dr is saying you shouldn't feel good, I think he is making the point that after your surgery you won't be fertile any more and won't need the same levels of estrogen, etc. that you have now. It's not age so much as life stage, and ours after surgery is menopause. Now, you may need to find your right dose, and Drs should be flexible in that regard, but I don't think yours is being mean.

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Unread 10-12-2010, 06:53 AM
Re: Why less ERT than I make naturally?

I believe the Drs that have the belief of using "just enough" HRT to relieve symptoms truly believe "less is more" because they are protecting their patient from "getting cancer" and they are protecting their own butts from liability at the same time. Maybe I'm being cynical here, but I believe it to be true. They follow medical studies that they deem as "right". They may believe they are protecting their patient from "harm"...so they end up watching some of their patients suffer needlessly...I just don't get it?
Plus I agree that to use too little HRT could be just as devasting to your body then using none at all. My body rebels when I use too little HRT. My philosophy is "listen to your body for it is wiser than you know".
Unless they (drs) themselves have experienced surgical menopause or their wives have, they can not truly have empathy of how devastating and life destroying it can be.

OK...I'll get down off my soapbox!
Unread 10-14-2010, 01:00 PM
Re: Why less ERT than I make naturally?

Thank you for your thoughts! I'm definitely going question my potential doctors closely and see what they have to say. I know that some of my fellow BRCA women on FORCE (facingourrisk.org) say docs go light on HRT (whether it's ERT or other variants) because of the threat of "triple negative" tumors--tumors that are fed by estrogen and other hormones. I'll just have to dig a little deeper! I'll report back what I learn.

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